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SCREENING FOR OVARIAN CANCER: A COMBINATION OF METHODS IS BEST.

No single method for the early detection of ovarian cancer is specific and sensitive enough to serve as a reliable screening protocol. Jacobs and colleagues studied 1010 postmenopausal women to determine the normal range for serum CA-125 (tumor-associated antigen) concentrations and the specificity of CA-125 measurements, ultrasound scans, and vaginal examinations, alone and in combination.

Serum CA-125 values ranged from less than 7.5 U/ml to 112.0 U/ml; the investigators determined that the upper limit of normal values falls between 23 and 30 U/ml. (Previous studies indicate that 80 percent of women with ovarian cancer have CA-125 values greater than 35 U/ml.) Alone, none of the methods achieved acceptable specificity. However, the combination of CA-125 and vaginal examination and the combination of all three tests resulted in 100 percent specificity. The combination of CA-125 and ultrasound was 99.8 percent specific.

The authors conclude that until another method of screening for ovarian cancer is developed, the combination of CA-125 and ultrasound is the most specific and sensitive protocol. Although the combination of CA-125 and vaginal examination was 100 percent specific, the authors recommend against its use because the vaginal examination lacks acceptable sensitivity.

— HGA

Published in Journal Watch General Medicine March 4, 1988

Citation(s):

Jacobs I; Stabile I; Bridges J et al. Multimodal approach to screening for ovarian cancer. Lancet 1988 Feb 6 1 268-271.

• Medline abstract (Free)